The health questionnaire looks at how your mental and physical illnesses affect your ability to work – this section only gives advice on mental illness. If you need advice about physical illnesses, you should contact another organisation that specialises in this.

You have four weeks to fill out the health questionnaire from when the Department for Work and Pensions (DWP) send it to you – the DWP are strict about this. If you need more time, you should tell them as soon as you can, but you will need to explain why you need more time and how much longer you need to finish the form. When you get your health questionnaire, you may want some help filling it in, and a local Citizens Advice or welfare benefits advice service may be able to help you. You can look for contact details in your local telephone book or on the Internet.

Page 4

Page 4 asks about your GP and any other healthcare professionals you work with, such as a:

Community psychiatric nurse (CPN),

Psychologist,

Psychiatrist, or

Social Worker.

You should put the contact details of the healthcare professional that knows you best, as they will be able to explain how your condition affects your day-to-day life and your ability to work.

Pages 7 and 8

These pages ask about your condition, how it affects you, and when it started. If your condition changes, or if you have good days and bad days, explain this here.

Page 8 asks about what medication you take and their side effects – you should include the following information in this section:

Any treatment you are having for your condition.

The medication you take or are going to start taking.

Any treatment you are on a waiting list for.

If you have psychotherapy, counselling or cognitive behavioural therapy (CBT).

If you get treatment and care from the Community Mental Health Team (CMHT).

If you have ever been in hospital under the Mental Health Act (‘sectioned’) or as a voluntary patient.

Scoring Points

To score points in the Work Capability Assessment (WCA), you must have a health condition that means you cannot work, and you need to score 15 points in total across the questionnaire to show you have limited capability for work.

You can score 6, 9 or 15 points for each question.

The first 10 questions ask about physical health. If you have any physical health problems, make sure you fill these sections in. If you don’t have physical health problems, you should tick the first box for each question, which says you can do the task without any difficulty.

Part 2 of the form asks about your mental health; these questions start on page 15. Mental health problems affect people in different ways. You may find that some questions don’t apply to you, but we have listed some things you may want to think about for each question in the table below.

You might also want to think about the following things:

It may be helpful to write out your answers on a separate piece of paper first and when you’re happy with them, you can write them on the form.

Take your time filling in the form. You may want to have a break and come back to it later. The more information you give the DWP, the easier it should be for them to make the right decision.

When explaining how your illness affects you, use examples that make it clear what you mean. You can use the same example more than once if it applies to more than one question.

When you think about if you can do things, you should think about if you can do them the same way all the time, for example, you may find it easy to go to a meeting once in a while but if you had to do it every week, coping with the meeting and behaving properly with other people could become difficult.

We have listed all of the mental health-related questions you will see on your health questionnaire below and have included some suggestions of things you can think about when filling in your answers.

We have included the descriptors in the Health questionnaire descriptors section. They show you what points the DWP will give you for your answers – it is important to think about this when you are filling in the form.

The questions on the form

Tips and suggestions

Q11 - Learning how to do tasks

Can you learn how to do an everyday task such as setting an alarm clock?

Can you learn how to do a more complicated task such as using a washing machine?

Does your illness or medication make it hard for you to concentrate on everyday tasks? These might be like setting an alarm clock or using the washing machine.

Was your concentration better when you were well?

Do you feel nervous about making a mistake?

Does this mean you just don’t try to complete the task?

Does it take you a lot longer?

Examples

I hear voices that make it hard for me to concentrate when trying to learn new tasks.

I get very anxious, which makes it hard to follow instructions. I get worried that I will do something wrong and so I have never learned to use the microwave.

If I have to do something new I think it will be hard so I avoid doing it. This means I don’t know how to use a computer and don’t go on the Internet.

The questions on the form

Tips and suggestions

12. Awareness of hazards or danger

Do you need someone to stay with you for most of the time to stay safe?

Sometimes people with mental illness can get easily distracted. This can mean they put themselves or other people in danger.

Do you ever start to make a meal, but then start doing something else and leave the cooker on?

Do you forget to lock your doors at night or when you leave the house?

Do you ever act dangerously and do things that you would not do if you were well?

Do you self-harm?

How often do these things happen? All of the time, most of the time or just sometimes?

Possible dangers are:

Self-harm,

Not being able to concentrate which means you don’t take medication correctly, don’t check ‘use-by’ dates or leave the gas on, or

Giving personal information about you to strangers.

Examples

My depressive thoughts are so bad that sometimes I forget that pans are hot and hurt myself on them.

I forget to turn off the gas most of the time because I am constantly worrying about other things.

If someone did not supervise me, I would take the wrong amount of medication. This would lead to me becoming unwell and hurting others or myself.

The questions on the form

Tips and suggestions

13. Starting and finishing tasks

Can you manage to plan, start and finish daily tasks?

Think about how your condition changes – what are you like on a ‘bad day’ compared to a ‘good day’? List all the tasks you might not be able to do.

Does your condition mean you don’t have any motivation?

Does your medication affect your concentration for everyday tasks?

How often does it affect you? Is it all the time, most of the time or not at all?

Do you need help to plan and organise your day?

What would happen if you didn’t have any help?

Are you sometimes lost in your own thoughts and, without encouragement from others, would sit on your own?

Would you stay in bed all day?

Would you not eat all day because you don’t have the motivation to make yourself something to eat?

Examples of ‘tasks’.

Planning – like cooking and preparing a meal.

Organisation – like booking an appointment with a doctor or paying bills on time.

Problem solving –dealing with something that happens unexpectedly like a washing machine that breaks down.

Prioritising – being able to know what the important things are that you need to take care of like dealing with money, paying rent or your bills.

Switching tasks – being able to do different things that are connected like washing dishes and then putting them away.

Examples

Because of my depression, I cannot find the motivation to plan and then make a meal for myself most of the time. I eat takeaways all the time.

When I am in a manic phase, I cannot prioritise what I will do with my money. This means I spend all the money I need for bills on stuff I don’t need.

My illness makes me think things that are not real. This means I can never go to appointments with my doctor because I think that people want to harm me.

I can’t cope with feeling under pressure to deal with problems. This means my back door has been broken for three months and someone could easily break in.

My medication makes it hard to concentrate. This means I can’t do things I need to do like chores or going to my GP.

The questions on the form

Tips and suggestions

14. Coping with changes

Can you cope with small changes to your routine if you know about them before they happen?

Can you cope with small changes to your routine if they are unexpected?

Do you find it hard to cope if your day-to-day routine is changed?

What would happen if you were told about a change? How would it make you feel?

If you are told about a change in your routine in advance (for example, if your doctors appointment changes), do you worry about it?

Does your ability to cope change from day to day or week to week?

What would happen if something unexpected happened? How would that make you feel?

Examples

Because of my Obsessive Compulsive Disorder (OCD), I have to go on the same bus route to my mother’s house every day. If there is an issue with the bus or a diversion I get very unwell. My symptoms get bad for days after and I can’t leave the house.

When I am unexpectedly asked to go to the Job Centre, I feel so anxious that I feel physically sick and can’t think about anything else.

If my routine changes, I think that the government are trying to interfere with my life. I don’t go out in case anything bad happens.

Even when I plan to go to a hospital appointment, I cannot go unless someone agrees to take me there.

If I run out of milk and bread I have a panic attack because I only get my weekly shop when a family member can help me on a Saturday.

If I get letters in the post that I don’t recognise, I don’t open them because I think they must be bad news.

If my sister cannot come and take me shopping when we agreed I get so angry I break things in my house. I feel angry for a few days.

The questions on the form

Tips and suggestions

15. Going out

Can you leave home and go out to places you know?

Can you leave home and go to places you don’t know?

Are you able to go out to places that you are familiar with on your own?

What would happen if you had to go out? Explain how that would affect you.

Can you only go out if someone is with you? Write down how often you need someone with you.

Do you need someone with you to make sure you don't cause any harm to yourself? How often could that happen?

Are you able to get to places that you don't know on your own?

Think about how you would cope:

Going on public transport,

Getting to doctors appointments,

Doing your food shopping,

Going to the bank,

Going to the Jobcentre Plus, or

Visiting friends or family.

Examples

I feel trapped when I am using public transport and start panicking and so I have to go back to my house.

When I have an appointment at the bank I can’t get there. I feel like everyone I walk past in the street is looking at me and wants to hurt me.

I always need to go out with someone, otherwise I start to feel anxious and get angry with strangers.

If I know I have to go somewhere new that is all I can think about. I start to panic and self-harm.

I live in the countryside so the buses only come every 30 minutes. If someone sits beside me on the bus I get so anxious I have to get off and wait for the next one. This means I am nearly always late for appointments.

The questions on the form

Tips and suggestions

16. Coping with social situations

Can you meet people you know without feeling too anxious or scared?

Can you meet people you don’t know without feeling too anxious or scared?

Think about how it would make you feel if you had to socialise with other people. If your ability to deal with social situations can change make it clear about how often and when you would have a problem.

Do you socialise with other people? If not, why?

What would happen if you did socialise? Would you show any physical symptoms? What are they?

Are you okay with people you know but don’t go to places where you would have to meet new people?

This could include having difficulties:

Using public transport,

Shopping,

Talking to neighbours,

Visiting friends or family, or

Taking part in hobbies.

Examples

I always avoid meeting new people. My heart races, I get dizzy and feel like I can’t breathe. I feel like I am in danger. Because of this, I do all my shopping online so I don’t have to interact with people. Even thinking about meeting someone new is on my mind for days before and I can’t sleep properly.

I feel really paranoid and I cannot trust people. If someone tries to talk to me I always tell them to get away from me.

If there are people on the street I won’t put my bin out.

I am not able to use public transport most of the time because it means I have to be around people I don’t know.

I never answer the phone unless I have agreed for someone I know to call me at a certain time.

I won’t answer the door unless I know who it is and I am expecting them.

I stay at home most of the time and only ask people I trust to bring me the things I need.

I don’t have a phone or email because I don’t want people to be able to hack into them and spy on me.

The questions on the form

Tips and suggestions

17. Behaving appropriately

How often do you behave in a way that upsets other people?

How do other people describe you?

Do people comment that they feel you are aggressive or violent?

Has anyone said they felt what you have said or done was inappropriate?

Have you noticed a change in the way people act towards you now compared to when you were well?

Have you lost friends or relationships because of how you behave?

How often do you find these things happen? Daily, a lot of the time or occasionally?

Examples

I often feel paranoid that people in the street are staring at me so I shout and swear at them.

I lost my last job because I got in an argument with my colleague and then shouted at my boss.

When I am on the bus I get really angry when people talk on their phone. I will tell them to shut up and have knocked people’s phones out of their hands if they don’t. I was arrested for this a few times, the police know me now.

I feel my neighbour has caused my depression so I write graffiti on their wall.

When I am in a manic phase I often try to have sex with lots of people, which makes it hard to have relationships.

When I have had panic attacks I have self-harmed at work and in public places.

I often say things that other people find insulting or inappropriate.

Part 3

This part of the form asks about eating and drinking. You need to fill in this section if you would not eat or drink and need someone to prompt and encourage you because of your illness.

Page 20

You will probably have to go to an assessment centre for a medical assessment. If you are unable to travel to an assessment centre or it is difficult for you, you can ask for a home visit. You need to put the reasons for this on page 20. More details on home assessments can be found in the ‘Will I have to go for a medical assessment?’ section.

You can write about any help you would need at a medical assessment on this page, so this may include taking someone with you. For example, you might require help getting out of bed and getting washed and dressed if you are very anxious about the assessment.

Page 22

You can write anything else that you think is relevant and will help the DWP make a decision on this page. You could include information on:

Sending back the health questionnaire

Before you send the form back, you should keep a copy of your completed form. This could help:

If you disagree with the DWP’s decision,

If the DWP lose your form, or

If you need to fill in a new form in the future.

You need to send the form back to the DWP and if you have to send the form back late, there is space on page 3 to explain why. If the reason is linked to your mental health, make sure you put this down on the form.

Supporting evidence

If possible, ask a professional who knows you well for a letter or report about your ability to work. This could be your GP, psychiatrist, Community Psychiatric Nurse or Social Worker. It can also be your Support Worker, Counsellor or Carer, as they can comment on how your mental health makes it hard for you to work – this is called supporting evidence. This evidence may help your claim. Staple it to the health questionnaire when you send it back. You could include medical test results of any physical health conditions, or your current prescription list, but make sure that you keep a copy of any supporting evidence.

Page 5 of the health questionnaire has a full list of what supporting evidence you can include and provides a full list of people that you can ask to give supporting evidence.

A letter that has more than just your diagnosis is better. This is because a diagnosis does not show how your illness affects you in everyday life. You could ask the professional to put the following information in it:

Explain how your condition affects your ability to work.

What could happen to your health if you were asked to start looking for work.

How you meet the specific criteria for the benefit.

Here's a sample letter that you can use to send to healthcare professionals when asking for supporting evidence.